PD16 Gaps in understanding of photoprotection in dermatology patients: what information should we be giving our patients?

Abstract

Effective photoprotection is essential for preventing skin cancer and photoageing, as well as managing photosensitive dermatoses. Patients often receive confusing, mixed messaging on sun exposure from a range of sources. We sought to clarify where knowledge gaps exist and to identify priorities for patient education. Two questionnaires were completed by adults (> 18 years) attending a dermatology outpatient department in North East England. Questionnaire 1 examined demographics, sunscreen behaviours, decision-making factors and understanding of terminology. Questionnaire 2 focused on photoprotection knowledge and future learning needs. Questionnaire 1 was completed by 244 participants (138 women), median age range 35–44 years. Unexpectedly for our population, Fitzpatrick skin type III was most commonly self-reported. Eighteen participants reported a sun-sensitive dermatosis and 13 a history of skin cancer. Sunscreen use included 9.4% (n = 23) daily use, 36.5% (n = 89) on sunny days in the UK and 22.5% (n = 55) only when abroad. The most influential factors when selecting sunscreen were sun protection factor, ultraviolet A rating and price. Patients were asked to rate agreement with statements and strongly agreed (mean value 9 out of 10) that sun rays contribute to burning, skin cancer and photoageing. Practical knowledge gaps were noticeable, with 82% (200 of 244) unsure how much sunscreen to apply. In questionnaire 2 (n = 30) several patients reported Fitzpatrick skin types inconsistent with their stated tanning ability, suggesting difficulty interpreting skin type. Sixteen (53%) wanted further general photoprotection information. Sunscreen was the most commonly used protection method (90%, 27 of 30), followed by protective clothing (43%, 13 of 30), shade seeking (40%, 12 of 30) and midday sun avoidance (23%, 7 of 30). Thirteen participants were unaware of ultraviolet A star rating when purchasing sunscreen. Key requested topics for further information included further understanding different types of ultraviolet, when to apply sunscreen in the UK, the correct amount and application, vitamin D requirements and guidance for babies. These surveys demonstrate important gaps in photoprotection knowledge, particularly correctly applying sunscreen. Patient education should prioritize practical, accessible information to support effective photoprotection behaviours.